If you suddenly wake up at night because of the burning pain in your toes, you are probably being attacked by gout.
Gout is a common and complex form of arthritis. It’s characterized by a sudden, severe attack of pain, swelling, redness, and tenderness in the joints. It’s often at the joint at the base of the big toe. It commonly attacks at the middle of the night with the sensation that the affected joint is on fire, making it hot swollen and so tender. When this happens, even the weight of the sheet may seem intolerable.
The Centers for Disease Control and Prevention (CDC) report that 8.3 million Americans were affected by gout between 2007 and 2008.
On a positive note, gout is a very controllable form of arthritis because of the vast availability of relevant medication.
But How Does Gout Occur?
Uric acid is produced in the body during the breakdown of purines. It’s a chemical compound that naturally found in the body. It’s also found in certain foods such as steak, organ meats, and seafood. Normally, uric acid dissolves in the blood and passes into the urine via kidneys. However, there are instances where either the body produces too much uric acid, or the kidneys excrete too little uric acid. Whichever the case is, uric acid can build up, forming sharp, needle-like urate crystals in a joint or surrounding tissue that cause symptoms such as:
- Intense joint pain: The pain is likely to be most severe within the first four to 12 hours after it begins. Primarily, the joint at the base of the big toe is the affected area. However, it can affect other joints such as ankles, knees, elbows, wrists, and fingers.
- Lingering discomfort: When the most severe pain subsides, some joint discomfort may last from a few days to a few weeks.
- Inflammation and redness: The affected joint/s become swollen, tender, warm and red.
- Limited range of motion: You may not be able to normally move your joints as gout progresses.
Uric acid is the primary reason for gout and the factors that can increase the uric acid level in the body. This includes diet, obesity, lifestyle choices, medical conditions, certain medications, genetics, age, sex, recent surgery or trauma, and other health problems.
Diet and lifestyle choices
Eating a diet that is rich in meat and seafood and drinking beverages sweetened with fructose (fruit sugar) increase levels of uric acid. This then increases the risk of gout. Additionally alcohol consumption, especially beer, also increases the risk of it as it interferes with the removal of uric acid from the body.
The body produces more uric acid and the kidneys have a more difficult time eliminating uric acid if you are overweight. Moreover, the more turnover of body tissue means more production of uric acid as metabolic waste product adds to the risk of gout. Higher levels of body fat also increase levels of systemic inflammation as fat cells produce pro-inflammatory cytokine.
Certain diseases and conditions increase the risk of gout. These include untreated high blood pressure and chronic conditions such as diabetes, underactive thyroid gland, metabolic syndrome, and heart and kidney failure. These can reduce the body’s ability to efficiently remove waste products, resulting in elevated uric acid levels.
Certain medications can increase the levels of uric acid in the body. Some examples are such as thiazide diuretics and drugs containing salicylate as well as low-dose aspirin.
If your family members have a history of gout, it is more likely that you will develop the disease.
Age and sex
Gout occurs more often in men as they have a higher level of uric acid. However, women tend to have the same level of uric acid as men as they pass through menopause. Experts also observe that men more likely to develop gout earlier, usually between the ages of 30 and 50. Meanwhile, women generally develop signs and symptoms after menopause.
Recent surgery or trauma
Surgery and trauma are associated with the risk of developing a gout attack.
Types of Gout
There are different stages through which gout progresses.
There is a possibility for a person to have elevated uric acid levels without any outward symptoms when it is still in asymptomatic hyperuricemia level. This stage does not require treatment, however, urate crystals are being deposited in tissue and causing small damage. Patient with this stage should take steps to address possible factors contributing to uric acid build-up.
This refers to the condition where the urate crystals suddenly cause acute inflammation and intense pain as it has been deposited. The sudden attack is called “flare” that normally subside within 3 to 10 days. Flares can sometimes be triggered by alcohol, drugs, stressful events, and cold weather.
Interval or Intercritical Gout
This stage refers to the urate crystals being further deposited in tissue and occurs between the attacks of acute gout. Subsequent flares may not happen for months or years. If not treated, they can last longer and occur more frequently over time.
Here are some lifestyle and dietary guidelines during a symptom-free period. For those who do not have a high level of uric acids, these guidelines can also help prevent a gout attack.
- Stay well-hydrated by drinking plenty of fluids around 2 to 4 liters a day. Limit drinking many sweetened beverages, especially those with high-fructose corn syrup.
- Limit or avoid drinking alcohol as there is recent evidence suggests that beer may be particularly likely to increase the risk of gout symptoms, especially in men.
- Get protein from low-fat dairy products as these products have a protective effect against gout. These are your best protein sources. So this means you should limit your intake of meat, fish, and poultry.
- Maintain a healthy or desirable body weight. Just choose portions that allow you to maintain a healthy weight. Losing weight may decrease the level of uric acid in your body. However, avoid fasting or rapid weight loss.